Commentary on popular culture and society, from a (mostly) psychological perspective

Monday, December 29, 2008

Is the health care gravy train on the way?

I was reading a comment by Steve Forbes in Forbes magazine today about health care and just had a few thoughts. If you have read this blog regularly, you will know that I am typically against universal health care. As is to be expected, Forbes says in a comment entitled, Sickening, that the Obama administration will make a hard-left push in health care, probably by signing a series of bills rather than trying to nationalize all at once.

He states that the Democrats will push a big reform bill that ostensibly deals with the 47 million uninsured Americans and that contains the following features:

Everyone must have health insurance, in the same way that most states mandate that all drivers have car insurance.

Private companies can write policies for people in this government pool, but they will have to meet numerous government mandates on what their policies must provide, as well as restrictions on what they can charge for premiums. In fact, the Obama Administration may mandate so-called community rating, in which everyone, regardless of age or condition, pays the same price for insurance. To mollify private insurers the feds will offer reinsurance above certain levels of liability.

At first, I balked at this plan (and it is not certain, of course, that this is the direction the Obama administration will take), but then I thought about it. Guess who pays for this mandated health care? Younger and/or healthier people.

That ain't me. The plan won't work unless the young and healthy subsidize those of us who have health problems and are older. With a heart attack, an ICD and in my forties, I'm going to be sitting pretty. I am already in the system. And now the younger, healthier people will be forced to contribute to pay for my battery changes, heart check-ups and other medical problems. Sounds good to me.

And it's not like the young liberal types are opposed to the idea of expanded health care. After all, those who are young activists are on Facebook and other sites clamoring for forced government health care. In addition, 68% of 18-24 year-olds voted for Obama as did 69% of the 25-29 year-olds (sorry to the 31-32% who did not--I sure don't want you subsidizing me). What these liberals don't realize is, they will most likely be the ones paying my way--but oh, well. As the saying goes, "Be careful what you wish for, you may receive it."

I have to agree with Quasimodo. You seem to be assuming that the government won't find some way to reduce the quality of service as a way reducing its cost. From a strictly utilitarian and rational point-of-view, the old and extremely sick should be denied treatment and euthanized. That's what we do to our pets.

You do realize I am being tongue and cheek here. I do not believe in nationalized health care. It is just that at least there is a silver lining if it comes to pass. Many of those who pressed for it at least will most likely be the ones paying for it. It would just be sort of ironic.

Call me old fashioned, but I prefer to wait till I see what bills are presented, debated,and signed rather than diss a "plan" that Mr Forbes thinks might get passed. Forbes, as I recall, has been wrong in the past.

I realize that, of course I think the government will reduce services. However, many of them will be reduced to those coming into the system, not the ones already there. For example, many doctors in MA where there is mandated insurance will not take on new patients. Many will keep the old ones however, so if one is an established patient, they might continue to get care. I have seen this with TennCare here in Tenn. Those who are already with doctors often continue to see them while others cannot get in if they are new.

I am not saying this is good, it's not and I do not think national health care is a good thing. It is evil in the sense that Quasimodo outlined. But if it comes to pass, at least those who voted for it may end up having to subsidize at least some of it. In other words, they will bear at least a bit of responsibility. Rather than use other's money, it might just come out of their own pocket at some point.

I am thankful that the young liberals are willing to buy me insurance for the rest of my life. I had to buy $275 worth of medicine today and I am thinking that Medicare drug coverage will be a sweet way to get that for nothing. Oh yeah - never did like those young whippersnappers...

The is nothing the government can't make worse. I can't wait for the government to take over healthcare and run it into the ground the way they have Social Security, mortgage lending and nearly everything else they touch.

Additionally, government and bureaucrats are for the most part untoachable by law. Try suing them for denial of benefits.

Pity the younger generation who will now be expected to finance this on top of Social Security. Doctor shortages are already projected. Will the best and brightest be as willing to travel the difficult road through medical school without the current financial rewards available? Not as many, I would think.

Government is notoriously inefficient, incompetent and unaccountable. Why would anyone would expect government run healthcare to be any different?

As PJ O'Rourke once observed, "if you think healthcare is expensive now, just wait till you see how much it costs when it's free."

More to the point, though, is an observation I once saw during my days in uniform -- and, having been the beneficiary of mandatory government-run health care whether I wished it or not (the only saving grace being, of course, that as a young aviator in my prime, I never got sick), one with which I can profoundly identify -- is this:

"Government health care: combining the compassion of the IRS and the efficiency of the Post Office - at Pentagon prices."

This already happened on the state-wide scale back in the early '90s in New York. At the time, I was in my early 20s and just out of college. I didn't have a job with health insurance, but I could by my own for $80 a month. It was basically catastrophic insurance, since there was a $1,500 deductible. But, I was young and healthy, and that was all I deemed I needed.

Enter the lawmakers of New York. A "community pricing" bill was passed. It accomplished the same thing you've described: namely, I would be put into a pool, along with the older and less healthy, and my health insurance would be priced accordingly.

My premium leaped up from $80 a month to $240 a month!

Needless to say, I just decided to go without insurance. I'm sure a lot of young people in my position did likewise.

When you're young -- apart from maybe your looks and lack of cynicism -- what have you got but your health?

So, the geniuses in New York's government accomplished two things with their law. On the same day I lost my health insurance and became cynical.

I think you're right Helen - the young and healthy will be punished for being young and healthy. Just another reason to escape to foreign lands, if you ask me. I mean, there must be somewhere in the world where freedom is still respected...right...?

What you won't like about the system is your access to it. Once the government controls the system, the only thing left to control is access. Wait till you find out that your battery check or replacement can't be scheduled for 9 months from now, even though it is due for replacment now.

One would think you would be correct, but the thing is, those who understand how the system works and who to go to will get better care, leaving those who are poor, uneducated or unable to work their way through the system and without care. Also, those with money can go to other countries if need be to get battery changes or other surgeries. My guess is that things like hip replacement will have a long waiting list as those services that are deemed non-life threatening will. Heart attacks, and such may be seen as more necessary. ...or not.

We'll just have to design our individual health needs around our gevernment's abilities.

The more education one has, the deeper one is invested in this crap, via longer exposure to the indoctrination procedures. Those teaching it certainly believe it. But they don't have to actually live it. The ones who became workers instead of professional students will be first to consider and realize they are only the producers. Even union workers will realize it eventually. Hopefully before union leaders and government leaders become one. When the producers wake up, and can take no more, there will be a massive explosion. The longer it takes, the worse it will be.

Also, those with money can go to other countries if need be to get battery changes or other surgeries.

Ah, but there's the rub. Those with enough money to go to other countries for medical treatment are by popular definition rich. Their taxes will be raised to the point where such trips are no longer possible.

Hate to be a spoilsport but I want my family and my neighbors to get the same health benefits members of congress get...we are in this together.

Lots of bitterness in comments but the simple fact is that Americans have voted in great numbers to say that the thing we had has not worked. Failed. Dump on govt, unions, liberals all you want but look what 25 years of "free market" has got us! What is your house worth today? And two years ago?

Some of us get health through our university jobs; others have nothing but the emergency rooms to go to. then, hospitals, to meet bills, charge insured clients. and insurance rates jump up to cover costs so in the end...we all pay for it! liberals and conservatives alike.

I spring from a tradition that says we are all our brothers and sisters, and those least fortunate ought to be cared for by those able to.

Now you can go back to reading Rand, the text on such matters, but John Galt is now working for a lobby firm and has an office on K Street.

Hate to be a spoilsport but I want my family and my neighbors to get the same health benefits members of congress get...we are in this together.

Yeah, that sounds sweet until you try to determine how much it's going to cost and who is going to pay for it.

Few problems are so bad that government can't make worse. Let's look at some of the areas where the government has ran health care and see if expanding it to everyone sounds like a good idea. Hmmm.

There's military health care (think Walter Reed). Is that an example of a well-run government health care system? Hardly.

How about the Veterans' Administration?

Or Medicare?

Or Medicaid?

Is there any US government run health care program (other than what members of Congress and the president get) that is an example to show they know what they're doing? I don't know of one.

Face it, if they can't run Medicare without billions in fraud and overruns each year with constant cutbacks in service, what makes anyone believe they can do a better job providing health care for everyone?

My thought, as a hardcore libertarian, is that we would all be better off if the government took on more and more responsibilities that it can't possibly meet.

The efforts of Republicans and Libertarians with libertarian leanings are obviously being wasted. Trying to pare back the size and scope of government is obviously a futile effort.

Therefore, the only other choice, as I see it, for people like myself is to encourage unrestrained growth in the size and scope of government until it collapses under its own weight. Social Security, Medicare, and Medicaid are already doing a fantastic job. The addition of more entitlements and the possibility of the addition of universal health care would speed the process along.

As for the burden that such policies would place on the young in the short-term, I say great! I've never been a fan of democracy and this recent election merely solidified my contempt for the process. The young were given opportunities to do the "right" thing and look out for their interests. Instead, they chose Obama. That being said, I hope they get everything they deserve.

"Therefore, the only other choice, as I see it, for people like myself is to encourage unrestrained growth in the size and scope of government until it collapses under its own weight..."

Kind of pulling a reverse John Galt. I plan on helping the government collapse under it's own weight by signing up for everything I'm entitled to. I was talking to a family member the other day who talked about staying healthy so she did not have to use any health care. I told her I was going to get my money's worth.

Dump on govt, unions, liberals all you want but look what 25 years of "free market" has got us! What is your house worth today? And two years ago?

Keep screeching that the free market has screwed up health care and housing all you want there, nathan, but it still doesn't make it so. Housing is hideously distorted and overregulated, as is health care.

The free market brought you 42" HDTVs for under $1000 and the hybrid cars, while the government brought you a credit crisis and a health care crisis. Learn the facts.

"Keep screeching that the free market has screwed up health care and housing all you want there, nathan, but it still doesn't make it so. Housing is hideously distorted and overregulated, as is health care."

Nothing can convince the "government is god and will save me" sheeple. They are religious believers.

No, in fact, Natasha Cornett had Medicaid but they rationed out 11 days of treatment and that was it so I am not sure how universal care would help. Perhaps with universal care, she would have been limited to 8 days of care?

A medical savings account, assuming they survive whatever may or may not be coming, potentially offers another means of "shrugging in plain sight." Negotiate directly with your doctor to pay the UCR (unless a big spike in reimbursement rates, which seems unlikely, prices one out of the market).

I like the idea of a multi-tiered health care system. It's one thing France has more or less done right. The idea is that everyone gets basic health care and basic means just that--what you'd get at a Walmart type clinic. If you want more, you can have more from private insurers.

That's the biggest problem with the proposed single-player plans. They demand a single system. They aren't really about providing health care, but about the government taking over the industry. It's about power, pure and simple.

(A big issue is actually the prescription medicine scam in this country. Most medicines don't really need a doctor appointment and even when you have one the doctor just asks a few stupid questions to make it seem like he's actually doing something and writes out the prescription.

Another thing is how many drugs really aren't that efficacious to begin with. It's amazing how many drugs, and expensive ones at that, aren't or just barely statistically better than a placebo or nothing at all.)

PS. My youngest daughter was born at home using a mid-wife. Cost us $500 out of pocket and my wife recovered much faster than her other four births, including a very premature birth. While not everyone's cup of tea, I find it very hard to justify the exorbitant cost of birthing in many places in this country.

My oldest daughter is about to have our first grandchild. Her doctor charges a flat rate of $2500 for everything, unless there is a C-Section and he's very reluctant to do those OR to induce labor. Insurance then covers whatever it covers (in her case it covers $1500 due to a $1000 yearly deductible.)

You mean 20 million illegal aliens, who are not Americans, without health insurance and 20 million young Americans too cheap to buy health insurance, which leaves 7 million Americans too stupid, lazy, in jail, where they get medical care anyway, or who pay up front for it.

I've given up trying to plug the dam with my little finger. Instead, I'm chipping away at the dam in any way that I can. I find as many ways as I can to avoid taxes and, like you, as many ways as I can to get as much as I can out of the government. I'm currently awaiting a decision from the VA about my eligibility for disability. I've convinced my father to try to sign up for SS disability because of his many ailments so that he can use up government before his own. I just wish that more libertarian-minded people would catch on.

Negotiate directly with your doctor

You know, I don't know why more people don't talk with their doctors about prices. I recently (about two months ago) had what I thought was a broken toe (it turned out to be a sprain). After several days of limping around with a swollen, blue toe, I finally decided that I had to do something about it. So, I started calling around to different doctor's offices and clinics. I started with the emergency room, figuring that I would be able to seen soonest there. The person in the ER didn't know what the costs of possible treatments were. Neither did the people to whom she transferred me to. Neither did the people that they transferred me to. I gave up on the ER and started calling several doctor's offices. I had more luck with getting a quote from them. Unfortunately, they charged a premium for seeing me ahead of other people who had appointments. I finally called an urgent care clinic, even though I was kind of leery about getting treated at what I considered the fast food of medical establishments. I was given a quote of $150 for the visit and an x-ray which would be reviewed by a radiologist, with possible extra, though not by too much, charges for possible treatments. I was offered additional care at additional costs which, after discussing the overall necessity of such care, I refused.

Having just got off of 5 years of military service in 2007, this was the first time that I'd been to a doctor's office without insurance. I learned a very valuable lesson: comparative shopping pays off. Had I gone to the emergency room at the hospital I would have incurred unknown charges that would have likely been far more than what I paid for the good service at the urgent care clinic. I've heard of doctors who only take cash payments that they and the customers agree to because of the hassle of dealing with insurance. I'm convinced that if the average person treated medical care like they do other products and services, costs might go down.

You mean 20 million illegal aliens, who are not Americans, without health insurance and 20 million young Americans too cheap to buy health insurance, which leaves 7 million Americans too stupid, lazy, in jail, where they get medical care anyway, or who pay up front for it.

Michael Cannon, an economist with Cato, discusses the 47 million figure here: http://www.cato.org/dailypodcast/podcast-archive.php?podcast_id=421.

I doubt too many people on this blog have family members or spouses paying for nice houses, cars and vacations. They are the ones paying for all that, I suspect. So, I'm not sure what your point is except to act petty.

Quasimoto wrote: They will also be the ones that will want the government to decide who should be terminated when the government doctor decides your life is no longer worth sustaining -

-or that you are refused treatment because you are too old (but not too sick) for a life saving procedure - _______________________________

I hate to disappoint ya but this is already happening under Republican and Conservative leadership: In Texas when he was Gov. Bush signed a law that does allow doc's and hospitals to withhold treatment from any patient who isn't expected to survive their illness...

Just this week it was reported by the Atlanta Newspaper the AJC that a woman who needed an intestinal transplant and was told here in Georgia (a red state that is controlled by so called compassionate Republicans and Conservatives) where she lived that medicaid wouldn't cover the cost and was forced to have the transplant in Ohio whose medicaid services did cover the operation...An operation that her doc here in Georgia stated that she would have needed to survive for more then the two or three years she was expected to live without the transplant...

I have always wondered why republicans and conservatives along with those who already have access to health care through their employer's insurance are so willing to practice stealth eugeneics: (spelling ?) (The weeding out of the population of those who are considered undesirable by the majority which was the original aim of those who promoted abortion on demand.) By with holding health care to those who don't have access to health care through their employer...

Their attitude seems to me about as cold blooded, calulating and as immoral as one can be and is on a par with those who demand the right to control their own bodies by seeking an abortion after discovering that unprotected sex does indeed have consequences yet refuse to take responsibility by living with the consequences of their choices...

Here is the problem with trying to shift the cost to younger payers. If you ask those that are just starting out in life to shoulder the burden of paying back their mounting student loans, buying their first car, paying their taxes, feeding themselves, paying for their own health insurance and then asking them to pay a portion of everyone elses' health insurance, my suspicion is that those young people will find a new home out of state or out of country.

Health care is a capitalism driven business. Health care providers are in it to make money, so they will find a way to make money any way they can. Right now pills are hot. Doctors get paid on how many patients they see in a day. So let's say you have some sort of ailment. You go to the doctor, he/she spends 5 minutes with you and then writes you a prescription. You get the prescription filled and hopefully your insurance pays for both the visit and the pills.

There is no incentive for the doctor to spend time with you, or instruct you to eat less red meat and french fries, or tell you to start exercising to cure what ails. If he did, most people would just get insulted anyway. Now if you really get sick and need major surgery, your insurance will pay for that too. All of this has a cost associated with it and there is absolutely no incentive on any part of this equation to rein in costs. If health care costs go up the medical industry simply passes the increase on to whomever is paying the bill....the government, employers and you.

The health care industry will always find new ways to make money. Bigger surgeries, transplants, pumps, expensive medicines to keep everyone alive a few more weeks or months. If one person incurs $2 million dollars worth of care, that cost will get distributed to everyone else on that person's plan. Fewer and fewer people will be able to afford insurance.

As a country, we've hit the wall. Hard choices are going to be made, whether you like it or not.

First and foremost health insurance is a scam and Ponzi like scheme that seeks financial contributions from the group it insures as a whole while seeking to deny benefits to those who actually need it...This why those with preexisting conditions are denied treatment for up to a full year after joining the insured group...Who in the case of private insurance and those who are self employed will more often then not receive a whopper of an increase in their premium just before becoming eligible to receive benefits...Which is intentionally designed by the insurance companies to be unaffordable and to prevent those who most need it from getting the treatment they need while maximizing their profits...

Properly managed universal health care would provide preventive and wellness care, vaccinate against infectious ﻿diseases and provide quality of life (hip replacements etc.) as well as lifesaving emergency and followup care...The cost of which could be designed to be borne by all in some measure instead of being foisted upon the next up and coming generation...

Treatment for optional non life threatening conditions such as breast augmentation, liposuction and cosmetic surgery (except for in the case of actual extreme disfigurement) would be borne by the seeker and not the group as a whole...

Properly managed universal health care would provide preventive and wellness care, vaccinate against infectious ﻿diseases and provide quality of life (hip replacements etc.) as well as lifesaving emergency and followup care...The cost of which could be designed to be borne by all in some measure instead of being foisted upon the next up and coming generation...

Ted Kennedy said the same things when he was pushing for the creation of Health Maintenance Organizations (HMOs) a while back. Funny how that didn't happen.

Name one government run health program that is "properly managed." Go ahead, I can wait.

I have always wondered why republicans and conservatives along with those who already have access to health care through their employer's insurance are so willing to practice stealth eugenics

I have always wondered why the left blames conservatives for these things. Projection? It is, after all, the left that is pushing for universal health care in the first place, including the emphasis on withholding care from the elderly and outright euthanasia of the aged.

Larry J wrote: Name one government run health program that is "properly managed." Go ahead, I can wait._____________________________Larry...

Why don't we take the gist of your comment to its most logical conclusion: That since our gov. can't properly manage health care or anything else for that matter it should just be eliminated in favor of every person for themselves...

Of course this would take us back to the Victoria era that so called compassionate conservatives pine away for in their daydreams...In which those who were less fortunate were allowed to live out their lives on the streets, debtors prisons and hovels...Hidden away from sight of those who thought themselves better but could neither run nor hide from the deadly plagues that overran both rich and poor in its path of utter destruction...

The ultimate fate of the nation at large is bound to that of those who are all too often ignored, neglected and mistreated because of their unpopularity...

Maybe Radian its because republicans and conservatives would much rather spend billions of dollars on wars to spread their version of democracy and bailout wall street...Then actually working together with liberals to create a better place for all of us in which to live work and play...

You don't have to go back to the Victorian Era, just back to WWII when government imposed wage controls caused companies like Kaiser Shipyards to offer health insurance as a benefit. What did people do before that? Simple, they paid the doctors when they went.

Government has distorted health care and the result is higher prices. For example, due to political bribes (AKA campaign contributions), many states mandate what types of coverage medical insurance must carry such as acupuncture and chiropractic care. All these mandates do is drive up the cost of insurance.

Now, people like you are calling for more government to solve the problems caused by government interference. Do you actually believe that will work?

Let the government prove they can properly manage their current health care programs before allowing them to force everyone into a government program. Or, if the concern is for the 47 million people who currently are said to lack medical insurance, set up a program for them. Why force the other 260 million people into a program if they already have insurance? The answer is simple - the goal is more power for government bureaucrats, not health care.

Maybe Radian its because republicans and conservatives would much rather spend billions of dollars on wars to spread their version of democracy and bailout wall street

Bush may be a Republican but he's not a conservative (as is McCain). Besides, even if I grant your premise, what does that have to do with my point? Your arguments are classic tu quoque. Republican bad acts don't justify or excuse progressive ones.

Actually Larry back then most people did without health care and died much earlier then the average person does today...

The plain and simple fact is that free markets do not work or stay stable over the long term without some form of regulation...Because they are prone to crashing due to the excesses that will always be imposed by the selfish nature of a few (Can you say Enron)...Which was proven in this economic downturn due in large part to the failure of properly regulating Fannie May and Freddie Mac and the rest of the housing sector and credit markets by both the lib's and and the repub's...But also has its roots in the North American Treaty as well as the outsourcing of blue and white collar jobs to other countries like Mexico, China and India...All of which have been heavily supported by conservative republican's...

When it comes to govt. interference conservatives are no different then liberals...Conservatives want to tell everyone else what drugs are legal and illegal and insist on jailing those who refuse to abide by their anti-drug laws...Then turn around and refuse to pay the taxes needed to build the prisons necessary to house their political prisoners...

I can't even send a money order through the US mail for 3 thousand dollars without having to fill out a special form...It is also illegal to carry large amounts of cash on my person and will be seized by the govt. if noticed or found on my person by a law enforcement agent...Nor can I deposit or withdraw my own money from my bank account in the amount of ten grand unless I conform by filling out another form for the govt...

All in the name of the war on drugs launched, maintained and funded by conservatives who have no problem what so ever in pressing their own ﻿ideological burdens on others but are too lazy, selfish and absolutely unwilling to lighten that burden in the least...

Randian republican conservatives have a well known nasty habit of preaching progressive conservative values in order to get elected...Only to turn around and do the exact opposite once in office just as they intended to do in the first place...Hence I came to the conclusion long before Bush was elected that their isn't any such thing as a progressive conservative in the republican party...

"I doubt too many people on this blog have family members or spouses paying for nice houses, cars and vacations. They are the ones paying for all that, I suspect. So, I'm not sure what your point is except to act petty."

------------------------

Although I'm not sure that MB is even talking about you, Doctor Helen, I AM sure that perceptive people here already have your number. You have a good, wealth-producing husband.

Although I have to admit that if you are even worth 1/10 of your arrogance, you are certainly paying for your husband. The funny thing is that I have never heard of YOU (Doctor Helen) except through your husband.

To be fair, typical American women take money and status from their husbands and THEN belittle them and cut them down. Doctor Helen apparently doesn't do the latter, so she's not as bad as a typical American woman.

Actually Larry back then most people did without health care and died much earlier then the average person does today...

Back then, there were no MRIs or CAT scans. There were no organ transplants, very little in the way of heart surgery, and a cancer diagnosis was an automatic death sentence. Before WWII, the only antibiotics in use were sulfa drugs. A simple infection could easily become a life threatening event. Do you suppose that medical advances in the past 60 years might've had a bigger impact on life expectancy than health insurance and government health programs?

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